[Hiring] Professional Lead Coder @Managed Resources

Role Description

The primary responsibility of the Professional Lead Coder is to code CPT, HCPCS, ICD-10-CM, Modifiers, Units based on medical record documentation in a remote environment and QA internal coders. Must have experience coding surgeries, E/M, and HCC/Risk Adjustment. Additional duties under the direct supervision of the Professional Coding Supervisor and/or Manager will include serving as a senior technical resource for the Professional Coding team.

The Professional Coding Lead provides subject matter expertise, assists coders with technical questions, supports quality assurance activities, monitors project workflow and coding volumes, and communicates potential issues or risks to leadership.

Qualifications

• Current CPC, COC, CCS, or CCS-P credential from AAPC or AHIMA required.
• Minimum of 5–7 years of professional fee coding experience involving CPT, E/M, HCPCS, and ICD-10-CM.
• Additional specialty coding credentials are highly desirable.
• Demonstrated experience performing high-quality coding within established turnaround times.
• Advanced knowledge of surgical and medical specialty coding as assigned.
• Extensive knowledge of medical terminology, anatomy, physiology, and coding principles.
• Demonstrated ability to research, interpret, and apply coding guidelines and regulatory requirements.
• Experience with multiple Electronic Medical Record (EMR) systems.
• Experience entering and validating coding information within databases and/or coding software applications.
• Advanced proficiency with Microsoft Office applications, particularly Outlook, Excel, and Word.
• High School Diploma or GED required.

Requirements

• Abstract and/or verify coding for assigned accounts using medical record documentation, including E/M, CPT, HCPCS, ICD-10-CM, modifiers, and units.
• Perform accurate coding in accordance with applicable official coding guidelines, regulatory requirements, payer guidance, and client-specific protocols.
• Pend and query accounts in accordance with client and Company expectations.
• Accurately verify and enter coding and related information into client software, EMR systems, databases, and/or Excel reports.
• Evaluate physician documentation to identify documentation concerns and opportunities for coding accuracy and quality improvement.
• Research and apply coding guidelines, regulatory requirements, payer guidance, and authoritative coding resources.
• Work complex, high-level, and problem work queues and accounts as assigned.
• Serve as a subject matter resource to coders by assisting with coding questions, coding guidelines, client protocols, documentation requirements, and workflow processes.
• Perform quality assurance reviews of coding work as needed/assigned and communicate findings, trends, and educational opportunities to the Supervisor or Manager.
• Assist with onboarding and technical training of new coders as requested.
• Support communication of project updates, coding guidance, work volumes, and due dates to coding team members as directed by leadership.
• Participate in client communication as requested by the Supervisor or Manager, including coding clarification, documentation questions, client meetings, EMR setup, and subject matter expertise.
• Assist with preparation and validation of internal and client-facing reports as requested.
• Identify opportunities to improve coding workflows, quality, consistency, and efficiency and communicate recommendations to leadership.
• Accurately track completed and pended accounts using client software and/or designated tracking tools.
• Accurately and timely record work hours in the Company's timekeeping system.
• Comply with policies governing the use and disclosure of protected health information, including accessing and using protected health information only to the extent necessary to perform assigned responsibilities.
• Maintain compliance with applicable federal and state laws, regulations, coding standards, and Company policies.
• Perform other duties as assigned that are consistent with the scope of the position.
• Demonstrate the ability to work independently, prioritize responsibilities, and manage workload effectively.

Benefits

• Medical, Dental, and Vision Insurance
• Phone and Internet Stipend
• Company-Paid Life Insurance
• 401(k) Retirement Plan with Company Match
• Paid Time Off
• Seven Company-Observed Holidays
• Two Floating Holidays for Personal Observance
• Professional Development Opportunities
• Employee Recognition Programs
• Remote Work Environment